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- W2981681194 abstract "Objective To find out the cause for the under-diagnosis of Lung Cancer (LC) at AMPATH by using community engagement and high-risk screening at the TB clinics. Methods FGDs with community cough monitors in counties were done due to overlap of LC and TB presentations. Consequently, through establishing a multinational-lung cancer control program (MLCCP) to improve diagnosis and patient journey for lung cancer patients in our settings, we classified patients with symptomatic lung disease (chest pain, cough, SOB, weight loss, hemoptysis) and negative gene expert/negative sputum for AAFB as high-risk for further evaluation. CT scans were done for anyone with a chest mass/lesion and Image-guided biopsy offered. s Jan 2018-Mar 2019, 331 high risk clients were evaluated. 214 with masses CT scans of which 205 were lung and 9 were mediastinal. 131/214 had biopsy, of which 83 (60 LC, 23 secondary mets) while 48 were other conditions. These included: Lung Fibrosis, Aspergillosis, Chronic granulomatous inflammation, TB, Thymoma, viral histiocytosis, Granuloma and unconfirmed diagnosis For the biopsied lung masses-131/214, 60 had confirmed LC. This represented 45.8% of those biopsied. Male to Female ratio was 1:1, median age at diagnosis was 62 with 55-74 age range accounting for 73.2% of LC cases. The mean duration of symptoms was 8 months, range of 1 to 12 months. >50% of the cancer patients made 7-10 hospital visits before diagnosis, with 25% making more than 14 visits. NSCLC accounted for 92.2% of the diagnosis with SCLC 7.8%. Adenocarcinoma was the commonest diagnosed histological sub-type at 66% of NSCLC. Majority of the patients were diagnosed at stage IV, 78.1% with only three patients diagnosed in stage II. 39% (25/64) patients are alive and on follow-up. Early detection is key. Poor referral patterns and lack of LC knowledge and diagnostic skills by HC professionals causes late stage at diagnosis. Patients do not present Late. Community engagement and embedding simple protocols for prompt referrals/diagnostic work-up in TB control programs may lead to improved outcomes. Prevention measures should also be rolled out. Cough monitors were essential to improving the LC patient's journey. *MLCCP is a Multi-National Lung Cancer Control Program with Dr. Asirwa the overall PI for Kenya, Tanzania, Swaziland and South Africa. Funding for the program has been provided by Bristol Myers Squib Foundation (BMSF) *MLCCP Team is the Kenyan Team for this Western Kenya Program Component" @default.
- W2981681194 created "2019-11-01" @default.
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- W2981681194 date "2019-10-01" @default.
- W2981681194 modified "2023-10-04" @default.
- W2981681194 title "P1.16-16 Lung Cancer Control in Sub-Saharan Africa: Experience at Ampath Oncology in Western Kenya" @default.
- W2981681194 doi "https://doi.org/10.1016/j.jtho.2019.08.1242" @default.
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